AccountId: 011433970860
ContactId: 341f9122-0624-424c-8e51-8e1088d17eb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399640 ms
Total Talk Time (AGENT): 142762 ms
Total Talk Time (CUSTOMER): 143870 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/341f9122-0624-424c-8e51-8e1088d17eb1_20250204T13:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office to check on claims. Can you spell your name, please?
[AGENT][NEUTRAL] Um, it's [PII] and my last initial is [PII].
[CUSTOMER][NEUTRAL] It's [PII], right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And um yes, I can assist you with claim status. Could I get your name and a good callback number?
[CUSTOMER][NEUTRAL] Uh my name is uh [PII]. It's [PII] Callback number is
[CUSTOMER][NEUTRAL] [PII] and the extension is [PII].
[AGENT][NEUTRAL] Thank you, Rogers. Now, could I get the policy number, please?
[CUSTOMER][NEUTRAL] It's 02388730.
[CUSTOMER][NEUTRAL] M Mike L Lima 7.
[AGENT][NEUTRAL] Thank you. Now, could I get the, please, well, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] The date of service and bill charges on the claim, please.
[CUSTOMER][NEUTRAL] It's uh [PII]. The amount is $400 even.
[AGENT][NEUTRAL] OK, one moment, please.
[AGENT][NEUTRAL] OK, thanks for your patience. Um, we received that claim on [PII].
[AGENT][NEUTRAL] The claim processed on [PII].
[AGENT][NEUTRAL] The claim number is 349-8527.
[AGENT][NEUTRAL] And this claim denied because we need the EOB from the primary insurance company.
[CUSTOMER][NEUTRAL] OK. We have already sent the primary UB.
[AGENT][NEUTRAL] I'm not showing that we've received it yet.
[CUSTOMER][NEUTRAL] It was sent via fax on [PII]. Fax number is [PII].
[AGENT][NEUTRAL] Yes, sir, that's correct. Did you guys attention it to the claims department?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] OK. I'm not showing that we received it, but it can be resubmitted. There is no timely filing limit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So fax number is correct, right?
[AGENT][NEUTRAL] Yes, that's correct. And make sure you attention it to the claims department.
[CUSTOMER][NEGATIVE] All right, and there's no timely filing to send the fax.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK. Uh, please confirm the claim number. It's 349-8527.
[AGENT][NEUTRAL] Yes, that's the claim number.
[CUSTOMER][NEUTRAL] OK. Uh, there's another claim for same patient for the not for the same reason. Can you check if you received the fax for that one?
[AGENT][NEUTRAL] Yes, what's the date of service?
[CUSTOMER][NEUTRAL] It's data service.
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] And the bill amount is uh $269 even.
[AGENT][NEUTRAL] Right. We still have not received the primary ELB for that one either.
[CUSTOMER][NEUTRAL] OK. May I know the date and then I date for this one?
[AGENT][NEUTRAL] Yes, we received this claim on.
[AGENT][NEUTRAL] We received it on [PII].
[AGENT][NEUTRAL] It denied on [PII].
[AGENT][NEUTRAL] And the claim, the claim number is 3504403.
[CUSTOMER][NEUTRAL] Claim number, please.
[CUSTOMER][NEUTRAL] 3504403. OK.
[AGENT][NEUTRAL] Yes. Mhm.
[CUSTOMER][NEUTRAL] OK. I have one more question. Can you check the last one?
[AGENT][NEUTRAL] Yes, what's the policy number? OK. What's the policy number?
[CUSTOMER][NEUTRAL] It's for different patients.
[CUSTOMER][NEUTRAL] OK, it's uh
[CUSTOMER][NEUTRAL] 02462244
[CUSTOMER][NEUTRAL] M as in Mike, L Lima, 8.
[AGENT][NEUTRAL] Thank you. Please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] It's uh [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] And the date of service and bill charges on her client?
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] Bill amount is uh $379 even.
[AGENT][NEUTRAL] OK, we received that claim on [PII].
[AGENT][NEUTRAL] It processed on [PII].
[AGENT][NEUTRAL] The claim number is 35543007.
[AGENT][NEGATIVE] And it's also denying because we need the EOB from the primary insurance.
[CUSTOMER][NEUTRAL] OK, need primary UB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Please confirm the claim number. It's uh 3554307.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, for there's no time for them to submit and same fax number. All details are the same. OK.
[AGENT][POSITIVE] That's correct.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK. Uh, we're done with the claims. Can I get the call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. And again, my name is [PII]. Last initial [PII], and today's date. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] It's uh [PII]. Last name initial is [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. Done with the claims. Thank you so much for the assistance. Have a great day.
[AGENT][NEUTRAL] You do the same, [PII]. Thank you for calling APL. Mm bye.
[CUSTOMER][POSITIVE] Thank you. Bye.